Find out if your mental health condition makes you eligible for the NDIS

Posted: January 18, 2022
Last updated: November 11, 2023
Table of Contents

Does the NDIS apply to mental health conditions? Our experts explain what types of mental illnesses are eligible for NDIS support and how to apply.

What mental health conditions are eligible for the NDIS?

If you have a mental health condition, you’ll know that managing your condition is hard work and you need a fair bit of support around you – which can be expensive. But did you know that you might be able to get funding to help pay for your support costs?

Some mental health conditions are eligible for the National Disability Insurance Scheme (NDIS). The term ‘mental health condition’ is very broad (it can include mood, anxiety, personality, psychotic and compulsive disorders, which can be temporary or lifelong), and only some people living with mental health conditions will qualify for the NDIS. This is because you need to be able to show that your mental health condition causes a psychosocial disability that is likely to be with you for life, and substantially affects your ability to manage day-to-day activities.

The NDIS provides government funding to people with a disability to help them pay for the services and supports they need because of their disability – for example, recovery coaching, support coordination or counselling. If you have a mental health issue you might not think of yourself as having a disability, but it’s worth looking into whether you qualify for the NDIS.

If your condition is permanent and affects your ability to do everyday things then the NDIS may help you to get the support you need.

Some of the mental health conditions which may be supported by the NDIS include,

  • schizoid disorders such as schizophrenia,

  • anxiety disorders such as post-traumatic stress disorder, obsessive compulsive disorder and agoraphobia,

  • mood disorders such as bipolar disorder and depression

In this article, we’ll look at how the NDIA decides who is eligible for the scheme, and what you need to do to apply.

Can you get NDIS for mental health?

You may be eligible for the NDIS if you have a psychosocial disability. Mental illness is considered a psychosocial disability if the mental illness is “significant” and makes it difficult to do everyday tasks such as going shopping, looking after yourself or working.

Eligibility criteria for a psychosocial disability

To apply for the NDIS for a psychosocial disability, you need to:

  • be under 65 years of age

  • live in Australia and be an Australian citizen or permanent resident

  • have a severe and enduring mental health condition that results in significant functional impairment (difficulty doing daily tasks) that requires ongoing support to help you with these daily activities.

So this means that diagnosis of a mental illness is not all you need to be eligible for the NDIS: you also need to be able to demonstrate that it results in a ‘functional impairment’ and that you need support for everyday tasks.

The illness can be ongoing or episodic but you need evidence that it is likely to be with you for life. Your support needs might fluctuate but it is likely that you will require NDIS ongoing supports. If you only need support periodically, you are not likely to meet the eligibility criteria for NDIS supports.

Applying for the NDIS for a mental illness

If you think that you meet the eligibility criteria for the NDIS and would benefit from NDIS supports such as recovery coaching, the first step is to fill out an NDIS Access Request. You need to provide quite a lot of information with your request, so be prepared to spend some time getting it all together. You might want to ask somebody to help you (more on this later).

As part of the NDIS Access Request, your psychologist, doctor, support worker or mental health nurse will need to complete an Evidence of Psychosocial Disability form. This includes information such as:

  • How long they have treated you

  • Information about any hospital admissions

  • Medication, treatment and interventions trialled or underway

  • Any clinical interventions

  • Confirmation you have a mental health condition, resulting impairments and whether these are likely to be permanent

  • An assessment of your life skills.

Showing ‘significant functional impairment’

When applying for the NDIS, you need to show evidence (which can be part of the information from your treating practitioners) that your mental health condition results in substantially reduced capacity to carry out activities in at least one of six areas, which are:

  1. Mobility – Do you find it difficult to leave the house, use public transport, go to shopping centres, and recreational or vocational activities or experience mobility difficulties as a result of side effects of treatment (e.g. tremor)?

  2. Communication – Do you experience difficulty in initiating or maintaining a conversation, communicating their needs or wants, or in following instructions, conversations or directions?

  3. Social interactions – What is your level of trust in other people? Do you experience difficulty in social interactions and maintaining relationships with family, peers or in the workplace?

  4. Learning – Do your mental health conditions impact your planning, memory, concentration on or ability to learn new information on or participate in group learning (e.g. tutorials)?

  5. Self-management – Does your mental health condition impact your ability to manage personal finances, maintain accommodation/housing and meet your responsibilities? Does the mental health condition impact your motivation, interest in life, or ability to concentrate or prioritise tasks?

  6. Self-care – Does your mental health condition impact how well you manage your physical wellbeing (diet, exercise, personal care/ grooming), medication or sexual health, or does it result in non-accidental self-injury?

In addition to the Evidence of Psychosocial Disability form, any assessments or other reports from your treating psychiatrist or health professional are particularly helpful with your application.

The most important thing to focus on in your application is explaining the way your condition impacts your ability to function day-to-day. You should also provide information showing how your disability impacts on your social and economic participation (such as getting and keeping a job).

Getting help applying for the NDIS

This might all sound daunting and overwhelming to you – and you wouldn’t be the only person to feel that way! The NDIS can definitely be complicated.

The good news is that there are people who understand the system and can help you navigate it – your mental health professionals would have prepared evidence for NDIS applications before, so they can help you put together some of the information and evidence you need. If you’ve seen different practitioners on your journey, you may need to contact several of them to get everything together for your application.

Friends, family, and social or community workers may also be able to help you find out what you need, help you collect the documentation and may also be able to provide evidence to support your application request.

You can also ask the National Disability Insurance Agency (NDIA) about people or organisations that can give you advice on the type of evidence and supporting information required.

At Goal Coach, we’re experts in mental health and the NDIS so you can always give us a call and we can give you some tips and point you in the right direction.
Book a free 15-minute chat if you already have a NDIS plan and we will support in your journey to living a more fulfilling life.

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